- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,623.41 / $7,762.47
| Facility | | $1,621.81 | $5,623.41 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $245.47 / $426.58
| Professional | | $158.49 | $245.47 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,162.28 / $7,413.10
| Facility | | $1,318.26 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $354.81 / $501.19
| Professional | | $288.40 | $354.81 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $275.42 / $407.38
| Professional | | $194.98 | $275.42 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $302.00 / $891.25
| Facility | | $186.21 | $302.00 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $354.81 / $575.44
| Professional | | $269.15 | $354.81 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,456.54 / $8,912.51
| Facility | | $4,570.88 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $549.54
| Professional | | $275.42 | $371.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $269.15 / $4,570.88
| Professional | | $229.09 | $269.15 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $281.84 / $426.58
| Professional | | $194.98 | $281.84 | $426.58 |